Lesbian and bisexual women’s health

Guy’s and St Thomas’ NHS Foundation Trust is committed to meeting the health needs of all our patients. We are also determined to reduce health inequalities experienced by certain groups. The particular health needs of and bisexual women are often overlooked, despite the fact that in some areas, lesbians and bisexual women have poorer health outcomes compared to women in general. We want to tackle this.

Lesbians and bisexual women become ill like everyone else. However, they can also have some distinct health issues. By being aware of these health issues and having the relevant health checks, you can keep healthy and reduce your risk of illness. If you are a or a bisexual woman, please read on and learn about looking after your own health and what services are out there for you.

We want you to know that our services are -friendly. We will treat you with dignity and respect, and consider your individual needs. If, however, you do encounter poor treatment, please do tell us, because we’ll want to make improvements. You can contact the Patient Advice and Liaison Service (PALS) if you have a concern or want to raise a complaint.

You can:

 call PALS: 020 7188 8801 or 020 7188 8803

 email PALS: [email protected]

 write to PALS: PALS c/o KIC Ground floor, North Wing St Thomas' Hospital Westminster Bridge Road SE1 7EH

Alternatively, you can fill in our online feedback form: www.guysandstthomas.nhs.uk/contact-us/feedback-form.aspx

The information in this pack addresses some of the particular health issues that are more common to lesbians and bisexual women, and lists a number of services providing information and support. If you have any questions or would like further information, please contact the individual services listed.

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Alcohol and drugs Lesbians and bisexual women drink more alcohol, and more often than the general population. Alcohol is linked to liver disease, increased risk of heart attack, adult-onset diabetes, obesity and some cancers. Drug use amongst lesbians and bisexual women is also significantly higher than for women in general.

If you would like support regarding alcohol use and/or drug taking, please contact one of the following:

The Three Borough Health Inclusion Team is a community nurse-led team providing health advice and support across Lambeth, Southwark and Lewisham. They are all drop-in services, so you don't need an appointment. They can provide healthcare advice, and can also offer further information on the best alcohol and drug service for you. t: 020 3049 4550 / 4555 / 4700.

The Club Drug Clinic offers a one-stop screening appointment that covers both the physical/medical and addiction aspects of recreational drug use. You can be referred to this service by any of Guy’s and St Thomas’ services, such as the Three Boroughs Health Inclusion Team.

Lambeth Early Intervention and Prevention Service provides services in Lambeth that help you to better look after your health. This includes support to reduce your alcohol consumption, stop smoking, lose weight and be more active. t: 020 3049 5221 e: [email protected] Address: Moffat Health Centre, 65 Sancroft Street, London, SE11 5NG

Antidote is a drug and alcohol support service run by and for the LGB&T communities. This service gives free non-judgemental advice and support delivered by trained staff and volunteers, all of whom identify as lesbian, gay, bisexual or , and who have a good understanding of the pressures and problems that come with recreational drug or alcohol use. The service includes a monthly drop-in clinic for women. t: 020 7833 1674 (10am to 6pm, Monday to Friday – ask for one of the Antidote Team) e: [email protected] w: www.londonfriend.org.uk/get-support/drugsandalcohol

Blenheim is a charity that provides a range of support services for drug and alcohol users, and their families and carers. Services operate across London, including targeted services in Lambeth and Southwark. t:: 020 7582 2200 w: www.blenheimcdp.org.uk

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Smoking Lesbians and bisexual women are more likely to smoke or to have ever smoked than women in general. If you smoke, local Stop Smoking Services can help you quit.

Southwark community stop smoking service t: 0800 169 6002 or 020 3049 8550 e: [email protected]

Lambeth community stop smoking service t: 0800 856 3409 or 020 3049 5186 e: [email protected]

Hospital (Guy's and St Thomas') stop smoking service t: 020 7188 0995 e: [email protected]

Southwark council stop smoking service t: 0203 228 3848 Address: Clinical Treatment Centre, Maudsley Hospital, Denmark Hill, SE5 8AZ

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Cancer More than one in three people will develop some form of cancer during their lifetime. There are certain things you can do to reduce your risk of cancer, like eating healthily, taking regular exercise and not smoking. There are also ways to spot the early signs of cancer. At Guy’s and St Thomas’ we have a range of cancer services. w: www.guysandstthomas.nhs.uk/our-services/cancer/overview.aspx

Cervical cancer Many lesbians think they do not need to have cervical smear tests – this is not the case. The Human Papilloma Virus (HPV), which can cause cancer, can be transmitted through lesbian intercourse. If you are between the age of 25 and 64, no matter what your , you should be getting a cervical smear test every 3–5 years. More information can be found on the NHS Choices website.

To find your local centre visit: www.nhs.uk/chq/Pages/964.aspx?CategoryID=69&SubCategoryID=694

Breast cancer Some research suggests that lesbians are at a higher risk of breast cancer than women in general. It is important that you regularly check your breasts for changes, such as lumps, rashes, pain, dimpling, and thickening of skin. If you are aged 50 or over, you should go for breast screening every three years.

Guy’s and St Thomas’ breast cancer risk assessment service is available in Lambeth, Southwark and Lewisham. t: 020 7188 1385 w: www.guysandstthomas.nhs.uk/our-services/genetics/clinics/breast-cancer-risk- assessment.aspx

Lung cancer Lung cancer is one of the most common cancers, and in most people lung cancer is related to cigarette smoking. As lesbians and bisexual women are more likely to smoke or to have been a smoker than women in general, it is especially important that you are aware of the symptoms. If you have had a persistent cough for more than three weeks, it is important you see your doctor. It probably isn’t anything serious, but finding lung cancer early makes it much more treatable.

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Emotional wellbeing Lesbians and bisexual women are more likely than women in general to experience mental ill health, such as self-harm and suicidal thoughts. This can often be linked to experiences of bullying or . While it can be difficult to seek help, it is important for you to know that there is support out there if you need it. If you want support regarding your emotional wellbeing and mental health, please contact one of the following:

South London and Maudsley NHS Foundation Trust (SLAM) can provide you with help if you are experiencing mental ill health.

Information line: 0800 731 2864 w: www.slam.nhs.uk/our-services/type-of-service

‘Talking therapies’ services are available to anyone aged 18+ living in Lambeth, Southwark, Lewisham or Croydon. Services are offered to people experiencing mild to moderate depression, general anxiety and worry, panic attacks, social anxiety, traumatic memories and obsessive compulsive disorder. We also offer help with other problems, including anger, eating disorders, relationship or sexual difficulties. w: www.slam-iapt.nhs.uk

Lambeth talking therapies t: 0203 228 6747 e: [email protected]

Southwark Psychological Therapies Service t: 020 3228 2194 e: [email protected]

PACE is London's leading charity promoting the mental health and emotional well-being of the LGB&T community. t: 020 7700 1323 e: [email protected] w: www.pacehealth.org.uk

Outcome is part of Islington MIND and is a day centre facility for LGB&T people with mental health problems. The service provides one-to-one and group support, a midday meal, activities, therapies, and a warm and friendly atmosphere to socialise in. t: 020 7272 5038 e: [email protected] w: www.islingtonmind.org.uk/outcome.asp

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Eating and body image Lesbians are just as likely as heterosexual women to experience eating disorders, and bisexual women have higher rates of eating disorders. If you have, or you are worried that someone close to you has a problem with their eating or body image, the following services are available to you:

The Eating Disorders Outpatient Service (at Maudsley Hospital) offers assessment, treatment and management for people with anorexia nervosa, bulimia nervosa, binge eating disorder or those with mixed eating disorder symptoms. The service provides a range of care packages tailored to the needs of patients and their carers. t: 020 3228 3180 w: www.slam.nhs.uk/our-services/service-finder-details?CODE=SU0312.

Beat is a nationwide organisation that supports people affected by eating disorders, their family members and friends, and campaigns on their behalf.

Adult helpline (18+): 0845 634 1414 Youthline (25 or under): 0845 634 7650 w: www.b-eat.co.uk

Domestic violence and abuse Just like heterosexual people, lesbians and bisexual women can experience domestic violence and abuse from partners and family members. Same-sex domestic violence is often not recognised and is under-reported. If you or someone you care about is experiencing domestic violence and abuse, whether psychological, physical, sexual, financial or emotional, you can get help:

REACH is a domestic abuse service based in the A&E department of St Thomas’ Hospital. The service supports women and men in heterosexual, same-sex and transgender relationships who are or have experienced abuse. t: 020 7188 8161 (Monday to Friday, 8am to 6pm)

Broken Rainbow is the national LGB&T domestic violence helpline and provides confidential support to all members of the lesbian, gay, bisexual and transgender communities, their families and their friends. t: 0300 999 5428 (Monday and Thursday 10am to 8pm, Tuesday and Wednesday 10am to 5pm (Tuesday 1pm to 5pm is a transgender-specific service) e: [email protected] w: www.brokenrainbow.org.uk

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Sexual health Like the rest of the population, lesbians and bisexual women are at risk from sexually transmitted infections (STIs). Many lesbians don’t think that they can contract STIs – this is not the case. Women can, and do, exchange fluids, and engage in sexual activity that can have consequences for a woman's health. For sexual health services you can visit:

Lloyd Clinic is a sexual health service at Guy’s Hospital, which provides a LGBT service called ‘The After Five Clinic' on Tuesdays from 4.20pm until 7pm. Burrell Street Clinic provides sexual health services at Blackfriars. All services are free and confidential. t: 020 7188 6666 w: www.guysandstthomas.nhs.uk/our-services/sexual-health/sexual-health-services.aspx

Pitstop for Women, run by the Metro Centre, is a clinic for women who have sex with women and is open on Wednesdays between 6.30pm and 8.30pm at 141 Greenwich High Road, London, SE10 8JA. It is free and confidential, and no appointment is necessary. w: www.metrocentreonline.org/sexual-health/testing-clinics

Pregnancy and maternity Lesbians and bisexual women have been parents for a long time. Some have children from a relationship with a man, some adopt, others become foster parents, and some enter into surrogacy agreements, co-parenting arrangements or use artificial insemination.

Under the Human Fertilisation and Embryology Act 2008, lesbian couples can now access fertility treatment in the same way as heterosexual couples. A pregnant woman’s partner can also, in certain circumstances, be recognised by law as the legal parent.

The Assisted Conception Unit at Guy’s and St Thomas’ offers a comprehensive fertility treatment service. Every step of the way you will be given all the advice and support you need, together with professional counselling services to help you cope with the stress and emotions involved in fertility treatment. t: 020 7188 2300 w: www.guysandstthomas.nhs.uk/our-services/acu/overview.aspx

Resources and further information can be found at: www.guysandstthomas.nhs.uk/our-services/acu/useful-information/resources.aspx

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Asking you about your sexual orientation Sometimes Guy’s and St Thomas’ and other healthcare organisations might ask you about your sexual orientation, along with questions about your age, gender, disability, and so on. We are not asking to be nosy. We ask to make sure we are providing the best possible service for all of our patients and that we are meeting your needs. All of your answers are kept entirely confidential.

Other useful links Information, advice and support  (national lesbian, gay and bisexual charity) Stonewall’s freephone information line provides information on a range of topics, including civil partnership and marriage, adoption, parenting, homophobic bullying, , discrimination and much more t: 08000 50 20 20 (Monday to Friday, 9.30am to 5.30pm) w: www.stonewall.org.uk  London Lesbian and Gay Switchboard This helpline provides free and confidential support and advice to LGB&T communities. t: 0300 330 0630 (daily from 10am to 11pm)

Socialising and support groups  London Bisexual Women’s group (social group) w: www.lbiwomen.bi.org  London Friend London Friend is a London-based LGB&T health and wellbeing charity. It offers support and advice, as well as running a number of group sessions on Caledonian Road, including: o Changes: a discussion and support-oriented group for women of all ages and backgrounds. o Fusion: a social group for black, Asian and ethnic minority lesbians and bisexual women. o Divas @ Friend: a social group for lesbians and bisexual women.  Opening Doors Age UK Provides information and support services to and with older LGB&T people): w: www.openingdoorslondon.org.uk

Housing Stonewall Housing Stonewall Housing is a specialist LGB&T housing advice and support provider. w: www.stonewallhousing.org  Albert Kennedy Trust Supports young, homeless LGB&T people in crisis. w: www.akt.org.uk

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Health  NHS Choices Provides information about all aspects of healthcare. w: www.nhs.uk  NHS Smokefree Offers advice on stopping smoking. w: www.smokefree.nhs.uk  Change4Life Advice on exercise and healthy eating. w: www.nhs.uk/change4life  Get Active London The largest Londonwide database of sports clubs, venues & activities. w: www.getactivelondon.com

Useful contacts

Patient Advice and Liaison Service (PALS) To make comments or raise concerns about the Trust’s services, please contact PALS. Ask a member of staff to direct you to the PALS office or: e: 020 7188 8801 at St Thomas’ t: 020 7188 8803 at Guy’s e: [email protected]

Language support services If you need an interpreter or information about your care in a different language or format, please get in touch using the following contact details. t: 020 7188 8815 fax: 020 7188 5953

Become a member of your local hospitals, and help shape our future Membership is free and it is completely up to you how much you get involved. To become a member of our Foundation Trust, you need to be 18 years of age or over, live in Lambeth, Southwark, Lewisham, Wandsworth or Westminster or have been a patient at either hospital in the last five years. To join, please call 0848 143 4017, email [email protected] or visit www.guysandstthomas.nhs.uk

Leaflet number: 3856/VER1 Date published: January 2014 Review date: January 2017 © 2014 Guy’s and St Thomas’ NHS Foundation Trust 9 of 9